代谢综合征(MS)对冠脉侧支形成的影响  

The impact of metabolic syndrome (MS) on coronary collateral formation

作　　者：沈伟[1] 潘俊杰[1] 施海明[1] 罗心平[1] 李勇[1] 朱军[1] 李剑[1] 金波[1] 李延林[1] 朱志栋[1] 倪唤春[1] 

机构地区：[1]复旦大学附属华山医院心内科,上海200040

出　　处：《复旦学报（医学版）》2014年第5期624-630,共7页Fudan University Journal of Medical Sciences

基　　金：上海市卫生局基金项目(2009006);复旦大学青年教师科研能力提升项目(20520133428)~~

摘　　要：目的研究代谢综合征(metabolic syndrome,MS)对冠脉侧支形成的影响,探讨其可能机制。方法2010年1月至2014年1月间,460位患者符合入选条件,组成研究人群。根据诊断标准筛选MS病例进行分组,分析冠心病患者的MS流行病学特点,通过冠脉造影评估侧支血流及血管病变严重程度,测定胰岛素抵抗指数(HOMA-IR)、纤溶酶原激活物抑制剂-1(plasminogen activator inhibitor-1,PAI-1)、脂连素(Adiponectin)等生物学参数。结果血糖升高、高血压、HOMA-IR、循环PAI-1和脂连素浓度与冠脉侧支血管生成减少之间存在独立相关性;多变量分析证实MS与侧支循环生发程度之间存在负相关。结论在冠脉血管闭塞的患者中,MS患者的冠脉侧支生成不及非MS患者,可能部分与空腹血糖、胰岛素抵抗相关的关键参数有关。Objective To investigate the impact of metabolic syndrome （MS） on coronary collateral formation,and to discuss it＇s potential underlying mechanisms. Methods Between Jan. , 2010 and Jan. ,2014,460 patients were prospectively enrolled with the inclusion criteria in the study population. They were grouped according to the diagnostic criteria and analyzed by epidemiological characteristics. We assessed collateral blood flow and vascular disease severity by coronary angiography,and examined the biological parameters of HOMA insulin resistance index （HOMA-IR）, plasminogen activator inhibitor-1 （PAI-1） ,adiponectin and others. Results Hyperglycaemia,high blood pressure, HOMA- IR,PAI-1 and adiponeetin concentrations were independently associated wih the decrease of coronary collateral angiogenesis. Meanwhile, we observed a negative relationship between MS and coronary collateral formation by multivariate analysis. Conclusions In patients with coronary occlusion, collateral circulation is impaired in patients with MS compared with non-MS patients, which may partly related to fasting glyeaemia and to key parameters linked to insulin resistance.

关 键 词：血管新生 侧支循环 冠状动脉疾病 代谢综合征(MS) 

分 类 号：R587.1[医药卫生—内分泌]